Diseases of the Colon & Rectum

Skip Navigation LinksHome > August 2008 - Volume 51 - Issue 8 > Local Excision of Distal Rectal Cancer: An Update of Cancer...
Text sizing:
Diseases of the Colon & Rectum:
doi: 10.1007/s10350-008-9231-6
Original Contribution: PDF Only

Local Excision of Distal Rectal Cancer: An Update of Cancer and Leukemia Group B 8984.

Greenberg, Jacob A. M.D.; Shibata, David M.D.; Herndon, James E. II Ph.D.; Steele, Glenn D. Jr M.D., Ph.D.; Mayer, Robert M.D.; Bleday, Ronald M.D.

Collapse Box


Purpose: The efficacy of local excision in the treatment of some early-stage distal rectal cancers is still being debated, because few high-quality, long-term prospective data on outcomes are available.

Methods: Fifty-nine patients with T1 lesions were treated with local excision alone, whereas 51 patients with T2 lesions received external beam irradiation (5,400 cGY) and 5-fluorouracil (500 mg/m2 intravenously Days 1-3, Days 29-31) after local excision. Kaplan-Meier curves were used to estimate the primary outcomes. The log-rank test and Cox's proportional hazards model were used to compare subgroups relative to these outcomes.

Results: With a median follow-up of 7.1 (range, 2.1-11.4) years, ten-year rates of overall survival were 84 percent for patients with T1 and 66 percent for T2 rectal cancer. Disease-free survival was 75 percent for T1 and 64 percent for T2 disease. Local recurrence rates for patients with T1 and T2 lesions were 8 and 18 percent, respectively, and rates of distant metastases were 5 percent for T1 and 12 percent for T2 lesions. T stage was a statistically significant predictor of overall survival (P = 0.04) and approached statistical significance as a predictor of disease-free survival (P = 0.07).

Conclusions: Local excision alone for T1 rectal adenocarcinomas is associated with low recurrence and good survival rates that remain durable with long-term follow-up. T2 lesions treated via local excision and adjuvant therapy are associated with higher recurrence rates.

(C) The ASCRS 2008


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.